Organization
GREATER CHARLESTON DIALYSIS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIAN L. ESPIRITU JR. M.D. (DIRECTOR)
(304) 720-2222
Entity
Organization
Contact information
Practice address
24 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303-1476
(304) 720-2222
(304) 720-2322
Mailing address
24 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303-1476
(304) 720-2222
(304) 720-2322
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
43517
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0071269-001
—
WV
Enumeration date
09/14/2005
Last updated
08/22/2020
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